In 2020 Gavin Ortlund published Finding the Right Hills to Die On: The Case for Theological Triage. The book explores the relationship between Christian fellowship and the various levels of importance that characterize Christian doctrine and practice. I believe that in this work Ortlund is wrestling with an important issue. I wish to test his argument for both its soundness and workability.

What I propose to do is to take Ortlund’s work chapter by chapter, devoting a short, evaluative essay to each. I plan to summarize his argument as I understand it, and then to offer my evaluation. As will become evident, my perspective lies somewhere within what I’ll call mainstream fundamentalism, by which I mean fundamentalism as it has most faithfully implemented its key insights in the face of ongoing developments. My hope is that interaction with Ortlund might bring clarity to some of the issues he addresses while at the same time helping fundamentalists to examine their own ideas and behaviors.

In his introductory chapter, Ortlund argues for the importance of theological triage. The language of triage comes from trauma medicine, in which providers must make choices about devoting scarce resources to the most urgent but treatable conditions during an emergency. By borrowing this expression, Ortlund is implying that Christianity faces an emergency. He underlines this point: “if souls were not perishing, if our culture were not seeming to escalate into a whirlwind of confusion and outrage, if the church did not have so many languishing needs—I suppose, if these were not the conditions we faced, we could do away with theological triage and work on every doctrine all at once” (18).

Faced with the necessity of triage, Ortlund ranks doctrines and practices according to four levels of importance: those that are essential to the gospel, those that are urgent for the health and practice of the church, those that are important to Christian theology, and those that are unimportant either to gospel witness or to ministry collaboration. The first rank doctrines are (as Ortlund elsewhere acknowledges) the fundamentals that distinguish Christians from non-Christians. The second rank doctrines may “cause Christians to separate at the level of local church, denomination, and/or ministry.” The third rank doctrines do not “justify separation or division among Christians,” apparently ever at any level. The fourth rank doctrines constitute matters that are indifferent and not theologically important (19 for all the above).

Ortlund acknowledges that not all doctrines or practices will fit his scheme neatly, but he advances it as a general framework for understanding (20). He then describes several imaginary situations in which Christians might have to make choices about their involvement in Christian activities. For the moment I will ignore these imaginary situations in the interest of offering an initial response to Ortlund’s proposal for theological triage.

First, and most importantly, Ortlund is correct that Christian doctrines and practices occupy multiple levels of importance. Of course, the most important distinction is between those of the first level (fundamentals) and those at all the other levels (non-fundamentals). This distinction has been recognized from very early in Christian thought.

How do fundamentalists respond to the distinction between fundamental and non-fundamental doctrines? The clue is in the name. The whole idea of fundamentalism is predicated upon that distinction.

Fundamentalists agree that acknowledgement of the fundamentals is essential to the existence of Christianity. The problem is that no Christian ever stops at mere confession of the fundamentals. The fundamentals are a foundation, but they are not a house. Confessing only the fundamentals is like trying to live in a foundation when no house has been erected upon it. The superstructure of the Christian faith requires acknowledgement of more than the fundamentals.

The fundamentals are essential to the bare existence of a hypothetical Christianity, but they are woefully inadequate for the full obedience of real-world Christians. Full obedience—obedience to the whole counsel of God—requires much more. More is essential to the whole counsel of God than is essential to the gospel. It is over the exact content of this “more” that Christians disagree. In view of these disagreements it is not possible for each Christian to fellowship with every other Christian at every level.

For fellowship is experienced at various levels as well. What these levels are is a subject for a different conversation. For the moment it is enough to note that Ortlund, in subsequent chapters, does recognize that different levels of fellowship require different levels of doctrinal and practical agreement. Consequently, Christians must integrate at least two considerations: levels of doctrine, including practice, and levels of fellowship. How to overlay these two grids upon one another is a topic worthy of discussion and study.

In that discussion, I am not sure that the image of triage will prove particularly helpful. Health care providers implement triage in emergency situations. For example, a provider may choose to delay treating a broken leg in favor of treating a sucking chest wound. Resources go to alleviate the immediate threat. Does that image help us to understand Christianity, though? Do we really want to leave people lying around with broken legs?

To map the triage model onto Christianity is to say that the church has no normal existence, but that it lives in a perpetual state of emergency. Ortlund cites certain circumstances to prove that we are in an emergency, but these are mostly just the normal environment in which the church operates. We are surrounded by unsaved souls, hostile cultures, and “languishing needs” (whatever that means). Yet the apostles faced these same circumstances, and they still found ways to proclaim all the counsel of God. They did not leave people lying around with theological broken legs.

Of course, emergencies do arise, such as the intrusion of religious liberalism a century and a half ago. That was an emergency. Christian institutions were being pirated by theological brigands. This pressure produced a natural tendency to downplay non-fundamentals in favor of a united front against the enemy. Even then, however, leading figures such as the Baptist Oliver Van Osdel and the Presbyterian J. Gresham Machen insisted that they stood for more than the fundamentals, and they rejected the label fundamentalist when it implied any watering down of their other doctrinal distinctives.

Scripture never seems to speak in terms of triage. It does speak in terms of full equipment (1 Tim 3:17). To be fully equipped, Christians must certainly master the fundamentals, but they must also master the more advanced teachings of the faith. There is more to the faith than the fundamentals, and all of it is essential to some level of obedience. Is it possible that all of it could also be essential to various levels of fellowship? How well Ortlund will answer that question remains to be seen.


This essay is by Kevin T. Bauder, Research Professor of Historical and Systematic Theology at Central Baptist Theological Seminary. Not every one of the professors, students, or alumni of Central Seminary necessarily agrees with every opinion that it expresses.


Happy the Church, Thou Sacred Place

Isaac Watts (1674–1748)

Happy the church, thou sacred place;
The seat of thy Creator’s grace;
Thy holy courts are his abode,
Thou earthly palace of our God.

Thy walls are strength, and at thy gates
A guard of heavenly warriors waits;
Nor shall thy deep foundations move,
Fixed on his counsels and his love.

Thy foes in vain designs engage;
Against his throne in vain they rage;
Like rising waves with angry roar,
That dash and die upon the shore.

Then let our souls in Zion dwell,
Nor fear the wrath of men or hell;
His arms embrace this happy ground,
Like brazen bulwarks built around.

God is our Shield, and God our Sun;
Swift as the fleeting moments run;
On us he sheds new beams of grace,
And we reflect his brightest praise.